Telemedicine Consultation Utilization in Georgian Penitentiary Institutions: A Retrospective Descriptive Observational Study

Background: Telemedicine represents a rapidly evolving tool for delivering specialist healthcare in structurally constrained environments. Correctional facilities face significant barriers to in-person specialist care, and telemedicine offers a scalable solution. This study provides the first systematic description of telemedicine utilization across Georgian penitentiary institutions following the introduction of teleconsultation services. Methods: A retrospective descriptive observational study was conducted using anonymized administrative data from the Special Penitentiary Service of Georgia. All registered telemedicine consultations conducted across the entire national penitentiary system between 7 June 2023 and 18 February 2025 were included. Data were analyzed by medical specialty, facility type, and patient sex using descriptive statistics and the Chi-square (χ2) test. Utilization volumes were contextualized using institutional bed capacities. Results: A total of 347 teleconsultations were recorded across six medical specialties. Endocrinology was the most frequently utilized specialty (n = 123; 35.45%), followed by gastroenterology (n = 92; 26.51%), rheumatology (n = 61; 17.58%), nephrology (n = 49; 14.12%), hematology (n = 21; 6.05%), and otorhinolaryngology (n = 1; 0.29%). Consultations involving male inmates accounted for 72.89% of all recorded consultation events (n = 253); note that the unit of analysis is the consultation, not the individual patient. All endocrinology consultations were conducted exclusively with male inmates. Hematology consultations were predominantly conducted with female inmates (90.48%). Closed-type and special-risk facilities accounted for 68.88% of all consultations. Temporal analysis revealed highly divergent trajectories across medical specialties; while endocrinology exhibited an accelerating upward growth pattern, gastroenterology showed a fluctuating trend with a late-stage resurgence, and both nephrology and rheumatology demonstrated long-term downward trends. The overall utilization rate was 27.63 consultations per 1000 available beds. A highly significant statistical association was confirmed between patient sex and utilized medical specialties (χ2 = 139.11, p < 0.001). Conclusions: Telemedicine utilization in Georgian penitentiary institutions has grown steadily since its introduction, with endocrinology emerging as the dominant specialty. Differences in teleconsultation utilization by sex and specialty were observed, including the absence of recorded endocrinology teleconsultations among female inmates during the study period. Further investigation is needed to determine whether these differences reflect variations in clinical needs, referral patterns, or other factors influencing service utilization.